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Nevin Manimala Statistics

Electrical impedance tomography for non-invasive identification of fatty liver infiltrate in overweight individuals

Sci Rep. 2021 Oct 6;11(1):19859. doi: 10.1038/s41598-021-99132-z.

ABSTRACT

Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of cardiometabolic diseases in overweight individuals. While liver biopsy is the current gold standard to diagnose NAFLD and magnetic resonance imaging (MRI) is a non-invasive alternative still under clinical trials, the former is invasive and the latter costly. We demonstrate electrical impedance tomography (EIT) as a portable method for detecting fatty infiltrate. We enrolled 19 overweight subjects to undergo liver MRI scans, followed by EIT measurements. The MRI images provided the a priori knowledge of the liver boundary conditions for EIT reconstruction, and the multi-echo MRI data quantified liver proton-density fat fraction (PDFF%) to validate fat infiltrate. Using the EIT electrode belts, we circumferentially injected pairwise current to the upper abdomen, followed by acquiring the resulting surface-voltage to reconstruct the liver conductivity. Pearson’s correlation analyses compared EIT conductivity or MRI PDFF with body mass index, age, waist circumference, height, and weight variables. We reveal that the correlation between liver EIT conductivity or MRI PDFF with demographics is statistically insignificant, whereas liver EIT conductivity is inversely correlated with MRI PDFF (R = -0.69, p = 0.003, n = 16). As a pilot study, EIT conductivity provides a portable method for operator-independent and cost-effective detection of hepatic steatosis.

PMID:34615918 | DOI:10.1038/s41598-021-99132-z

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Olive Leaves (Olea europaea L) Extract Loaded Lipid Nanoparticles: Optimization of Processing Parameters by Box-Behnken Statistical Design, in-vitro Characterization, and Evaluation of Anti-oxidant and Anti-microbial Activity

J Oleo Sci. 2021;70(10):1403-1416. doi: 10.5650/jos.ess21149.

ABSTRACT

The present study was aimed to prepare and evaluated solid lipid nanoparticles (SLNs) of olive leaves extract powder (OLP) which contained many anti-oxidant and antimicrobial agents like oleuropein, a natural polyphenol. The major issue concern OLP was the instability due to environmental conditions and hence compromised bioactivity. To overcome this problem, SLNs were designed by hot homogenous followed by sonication technique to protect the drug and improve its antioxidant and antimicrobial activity. Lipids like compritol 888ATO and surfactant like tween 80 were used for the development and stabilization of SLNS and optimization was done by Box-Behnken statistical design (3×3). The optimized batch (F9) showed particle size, entrapment efficiency, PDI, and zeta potential 277.46 nm, 80.48%, 0.275, and -23.18 mV respectively. Optimized formulation (F9) exhibited a sustained release pattern up to 24 h with first-order release kinetic (R2 = 0.9984) and the mechanism of drug release was found to be Fickian diffusion type (n = 0.441). Upon the stability study, it could be found that SLNs formulation was stable. Anti-oxidation and anti-microbial studies were conducted on optimized formulation and findings suggested that SLNs showed an improved radical scavenging activity and anti-microbial activity against Gram-positive (Staphylococcus aureus) and Gram-negative (Pseudomonas aeruginosa) bacteria. Finally, it was concluded that developed SLNs were able to protect and suitable for the delivery of OLP.

PMID:34615828 | DOI:10.5650/jos.ess21149

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Clinical performance of monolithic CAD/CAM tooth-supported zirconia restorations: systematic review and meta-analysis

J Prosthodont Res. 2021 Oct 6. doi: 10.2186/jpr.JPR_D_21_00081. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this systematic review was to evaluate the survival rate, biological complications, technical complications, and clinical behavior of single crowns supported by teeth made up in monolithic zirconia with CAD/CAM technology.

STUDY SELECTION: An extensive electronic search was conducted through Medline/PubMed, Embase, and Cochrane Library databases. Additional manual search was performed on the references of included articles to identify relevant publications. Two reviewers independently performed the selection and electronic and manual search.

RESULTS: From nine articles included, there was a total of 594 participants and 1657 single-tooth restorations with a mean exposure time of 1.07 years, and follow-up period between 0.3 and 2.1 years. All studies showed a moderate level of quality, with a consequent moderate possibility of associated bias, using the Newcastle-Ottawa Scale (NOS), with survival rate (SR) ranging between 91% to 100%. Bleeding on probing (BOP) were reported with an average value of 29.12%. Marginal integrity showed high success rate values for the observation periods, except for one that included patients with bruxism which obtained a SR of 31.60%. Failures and/or fractures, mostly total and requiring replacement, were observed in three studies. Linear regression showed that there was no statistical correlation between survival rate and type of cementation and the average years of follow-up (p=0.730 e p=0.454). There was high heterogeneity between studies (I2 = 93.74% and Q = 79.672).

CONCLUSIONS: Within the limitation of this study, monolithic zirconia might be considered as a possible option for restoring single crowns, especially in the posterior zone.

PMID:34615842 | DOI:10.2186/jpr.JPR_D_21_00081

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Impact of Various Desensitizing Agents on Occlusion of Dentinal Tubules: A Scanning Electron Microscopic Study

J Contemp Dent Pract. 2021 Jul 1;22(7):829-832.

ABSTRACT

AIM: The aim of the present study was to compare the capacity of three dissimilar commercially accessible desensitizing products for the occlusion of dentinal tubules using a scanning electron microscope (SEM).

MATERIALS AND METHODS: The nondiseased human mandibular premolar teeth, ninety in number, were amassed for this study. The blocks subsequently made were subjected to polishing using abrasive paper to facilitate dentinal surface exposure. The samples were randomly allocated to one of the following three groups: Group I, samples to be treated with Admira Protect; Group II, samples to be treated with MI paste, Group III, samples to be treated with Remin Pro. Photomicrograph of every sample was taken to evaluate the occlusion of the dentin tubule under 2000× magnification of the SEM.

RESULTS: MI paste exhibited the greatest dentin tubular occlusion with a value of 2.746 ± 0.530 followed by Admira Protect (3.498 ± 0.202) and Remin Pro (4.594 ± 0.364) in that order. Amid the various desensitizing materials used, statistically significant differences (p <0.001) were noted.

CONCLUSION: Within the confines of the limitations of the present research, following a comparative assessment of the three desensitizing materials used, it can be concluded that all of them were efficient in sealing off the dentin tubules in spite of differing chemical constitutions and techniques of application. When compared with the agents, Admira Protect and Remin Pro, MI paste exhibited the maximum occluding capacity of the dentinal tubules.

CLINICAL SIGNIFICANCE: A short, sharp shooting pain characterizes the frequent problem of dentin hypersensitivity (DH). Sealing off the open dentin tubules, thereby reducing dentinal permeability, is a known method in the treatment of DH. As several agents exist to reduce DH, the best commercially marketed product for decreasing this condition by occluding the tubules should be identified by the clinicians.

PMID:34615790

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Tonsil Size and Mallampati Score as Clinical Predictive Factors for Obstructive Sleep Apnea Severity in Children

J Contemp Dent Pract. 2021 Jul 1;22(7):850-853.

ABSTRACT

AIM AND OBJECTIVE: The aim of this study was to determine the clinical utility of body mass index (BMI), tonsil size, and Mallampati scoring in predicting both the presence of and severity of pediatric obstructive sleep apnea (OSA).

MATERIALS AND METHODS: This prospective cross-sectional study comprised 78 growing children in the age range of 11-14 years with polysomnography (PSG)-proven OSA and 86 non-OSA corresponding controls. BMI, tonsil size (Friedman grading scale), and Mallampati score were determined for both groups, and related differences were assessed with a t-test, while their independent association with OSA severity was tested with a regression analysis. Statistical significance was set at p <0.05.

RESULTS: Male gender, BMI, tonsil size, and Mallampati score were significantly higher in the OSA group (p < 0.05). A significant correlation was recorded between the Mallampati score and OSA severity (p < 0.01), but not with BMI or tonsil size (p > 0.05). For every 1-point increase in the Mallampati scale, the apnea-hypopnea index (AHI) increased by more than five events per hour in the bivariate analysis and by more than three events per hour in the multivariate analysis.

CONCLUSION: Male gender, increased BMI, high tonsil, and Mallampati scores were clinical indicators of the presence of OSA. However, only Mallampati scale had a significant association with OSA severity. Clinical diagnostic indicators should be established and encouraged especially in community-based studies.

CLINICAL SIGNIFICANCE: Clinical diagnostic indicators are very useful in examining and screening children who are at risk of developing OSA as PSG is expensive and unsuitable for universal use in the pediatric population.

PMID:34615793

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Quantitative and Mathematical Analysis of Mental Foramen along with Its Correlation with Sex and Age Using Cone-beam Computed Tomography

J Contemp Dent Pract. 2021 Jul 1;22(7):793-798.

ABSTRACT

AIM AND OBJECTIVE: The aim of the present study was to perform quantitative and mathematical analysis of mental foramen (MF) along with its correlation with study subject’s sex and age using three-dimensional imaging like cone-beam computed tomography (CBCT).

MATERIALS AND METHODS: The CBCT scan images stored in the database were used in this study. Two-hundred sixty-seven scans were selected. They were divided into four different age-groups. These age-groups were 16-23 years, 24-38 years, 39-55 years, and more than 56 years. Each age-group was further divided into two subgroups. One subgroup was of males, while the other subgroup was of females. Following this, there was evaluation of all CBCT-scanned images considering certain parameters like position of MF, size of MF, distance X, distance Y, and distance Z.

RESULTS: The MF was located generally apically to the premolar and molar. It was more commonly located between the first premolar and second premolar among females, while in males, it was mostly located along the long axis of the second premolar. In most of the age-groups, the MF was located between the long axis of the first premolar and second premolar. The average distance of MF from the apex of first premolar was 5.01 mm. Further, the average size of MF and its distance from the base of the mandible were greater in males as compared with females. When all these measurements were compared in different age-groups, the difference was not statistically significant.

CONCLUSION: The average distance of MF from the apex of the first premolar was 5.01 mm. The average size of MF and its distance from the base of the mandible were greater in males as compared with females. When the measurements were compared in different age-groups, then the difference was not statistically significant.

CLINICAL SIGNIFICANCE: MF is an important structure in the mandible because it acts as an important landmark in the anesthetic procedure; therefore, there was a need to carry out detailed quantitative and mathematical analysis for MF.

PMID:34615786

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Resistance against Fracture in Teeth Managed by Root Canal Treatment on Restoring with Onlays, Inlays, and Endocrowns: A Comparative Analysis

J Contemp Dent Pract. 2021 Jul 1;22(7):799-804.

ABSTRACT

AIM AND OBJECTIVE: To compare the fracture resistance in teeth managed by root canal treatment after restoring with different types of onlays, inlays, and endocrowns prepared with hybrid ceramics and pulp chambers restored with fiber-reinforced composite and resin composite that were radiopaque, light-cured, and flowable.

MATERIALS AND METHODS: The present study was carried out on 252 extracted mandibular molars. All the specimens were divided into six groups randomly. Each group consisted of 42 specimens. Group 1 consisted of intact teeth without any access cavity. It was the control group. Group 2 consisted of teeth with endocrown and empty pulp chamber. Group 3 consisted of teeth with mesio-occlusal-distal (MOD) onlay prepared with hybrid ceramics and pulp chamber filled with flowable, light-cured, radiopaque resin composite. Group 4 consisted of teeth with MOD onlay and pulp chamber filled with fiber-reinforced composite. Group 5 consisted of teeth with MOD inlay and pulp chamber filled with flowable, light-cured, radiopaque resin composite. Group 6 consisted of teeth with MOD inlay and pulp chamber filled with fiber-reinforced composite. Inlay, onlay, and endocrowns were prepared with computer-aided design (CAD) and computer-aided machine (CAM) using hybrid ceramics. Universal testing machine was used for the measurement of the fracture resistance of each specimen. Inferential statistics were performed by applying Fisher’s exact test and chi-square test.

RESULTS: Fracture strength was found to be maximum in the intact teeth group followed by the endocrown. The fracture strength was minimum in the inlay group. The fracture strength was intermediate in the onlay groups.

CONCLUSION: Endocrown showed maximum fracture resistance as compared to the inlay and onlay restorations.

CLINICAL SIGNIFICANCE: Proper management of root canal-treated teeth is one of the greatest challenges for endodontists. It has been observed that tooth preparation design and the material used for the restoration of root canal-treated teeth play a vital role in the resistance against fracture in the teeth.

PMID:34615787

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Clinical Efficacy of Single Use of Three Different Mouthrinses on the Level of Streptococcus mutans in Saliva

J Contemp Dent Pract. 2021 Jul 1;22(7):769-773.

ABSTRACT

AIM AND OBJECTIVE: The aim of this cross-sectional population-based clinical study was to assess the effect of single use of three different mouthrinses on the level of salivary Streptococcus mutans of 8 to 10-year-old Saudi children.

MATERIALS AND METHODS: Convenient samples of 52 Saudi children aged 8-10 years were randomly allocated into four groups of 13 each. Saliva samples were collected to assess the level of S. mutans at baseline before rinsing with the assigned mouthrinse or control. Three mouthrinses, Avalon Avohex, Listerine Miswak, and Optima Aloe Dent Mouthrinse, were randomly distributed to the children. Each participant was instructed to rinse for 2 minutes using 10 mL of the assigned mouthrinse. Saliva samples were collected after rinsing and colony forming unit (CFU) of S. mutans per mL of saliva was calculated. Statistical analysis was performed to compare S. mutans count at baselines and postintervention values of each experimental group and control using paired t-test and one-way ANOVA. All statistical analyses were set at a significance level of p < 0.05.

RESULTS: All test groups showed a reduction in salivary S. mutans compared to that at baseline. Statistically significant reduction (p > 0.05) in bacterial count was seen in Avalon Avohex group.

CONCLUSION: A single-time rinse of chlorhexidine extract mouthrinse for 2 minutes effectively reduced the number of S. mutans of 8 to 10-year-old Saudi children.

CLINICAL SIGNIFICANCE: Rinsing with chlorhexidine extract mouthrinse should be considered as a potential method in prevention of dental caries in children.

PMID:34615782

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Evaluation of Anticaries Efficacy of Various Fluoride Varnishes on Artificial Enamel Lesion: An In Vitro Study

J Contemp Dent Pract. 2021 Jul 1;22(7):774-777.

ABSTRACT

AIM: Aim of the current study was to assess the anticariogenic effectiveness of different fluoride varnishes on artificially induced enamel lesions employing scanning electron microscope.

MATERIALS AND METHODS: Eighty healthy, normal premolars without dental caries that were extracted in course of orthodontic therapy with all the surfaces intact were included in this study. A window, 4 × 4 mm, was made discernible on the buccal surface of each sample tooth. A demineralizing solution at 37°C was used to immerse the teeth for 48 hours to induce artificial lesions on the surface of the enamel. Following preparation of the artificial enamel lesions, the 80 premolar teeth were allocated into the four groups (20 each) depending on the fluoride varnish system used as Group I: control, Group II: Duraphat varnish, Group III: MI Varnish, and Group IV: Clinpro White Varnish. The anticariogenic effectiveness of different fluoride varnishes was evaluated employing a scanning electron microscope (SEM).

RESULTS: The MI Varnish (fluoride varnish) group exhibited slightly greater (127.20 ±0.14) mean demineralized lesions, pursued by Clinpro White Varnish use (126.88 ±0.09), the control group (126.36 ±0.10) and the Duraphat varnish (124.14 ±0.08) in that order. Greater mean areas of remineralization were found with use of MI Varnish (92.40 ±0.09), pursued by the Duraphat varnish use (106.68 ±0.12), use of Clinpro White Varnish (112.36 ±0.08), and then the control group (123.08 ±0.18) in that order. Statistically significant differences were noted between the experimental groups employing the various fluoride varnishes (p <0.001).

CONCLUSION: The current research concluded that the MI Varnish group presented a superior protective potential in comparison with Duraphat varnish and Clinpro White Varnish groups.

CLINICAL SIGNIFICANCE: Mineral exchanges among teeth and saliva render incipient enamel lesions reversible. A 5% sodium fluoride varnish is the MI Varnish that is composed of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) to provide an excellent fluoride varnish that makes available additional bioavailable fluoride, calcium, and phosphate. Therefore, it may be fruitfully utilized in remineralization of initial carious lesions. CPP-ACP may be employed in clinical practice for drawing back or ceasing initial carious lesions. Rani KBS, Ramanna PK, Mailankote S, et al. Evaluation of Anticaries Efficacy of Various Fluoride Varnishes on Artificial Enamel Lesion: An In Vitro Study. J Contemp Dent Pract 2021;22(7):774-777.

PMID:34615783

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Effect of Bone Graft on the Correlation between Clinical Bone Quality and CBCT-determined Bone Density: A Pilot Study

J Contemp Dent Pract. 2021 Jul 1;22(7):756-762.

ABSTRACT

AIM AND OBJECTIVE: The aim of this pilot study is to explore the possible correlation between radiographic bone density and clinical bone quality in edentulous implant sites with and without a history of bone grafting.

MATERIALS AND METHODS: A retrospective evaluation of 273 surgically placed dental implants with adequate preoperative cone-beam computed tomography (CBCT) between 2017 and 2019. Misch classification was used to assess the bone quality, and CBCT grayscale values, utilizing Hounsfield units (HU), were used for radiographic bone density assessment.

RESULTS: Sixty-six patients (mean age, 58 years; 43 [65%] female and 23 [35%] male) with 118 implant sites were included. A total of 38 sites with bone grafts were evaluated. Controlling for location, sites with previous bone graft had softer bone quality (p = 0.003) and greater bone density (p <0.001) compared to sites without previous bone grafts. A significant correlation existed between radiographic bone density and clinical bone quality (p ≤0.01). The magnitude of the relationship increased in the absence of bone graft (p <0.001) and became nonsignificant in sites with previous grafting. In sites with allograft, the relationship was not statistically different than those without bone graft (both p ≥0.07), while it was statistically different in sites with xenograft when sites assumed independent (p = 0.02).

CONCLUSION: CBCT-determined radiographic bone density was correlated to clinical bone quality in the absence of previous bone grafting, while in the presence of previous bone graft, the radiographic bone density of the edentulous sites seemed to be not associated with the clinical bone density, especially in sites with history of xenograft bone grafting.

CLINICAL SIGNIFICANCE: CBCT could be utilized to predict preoperative clinical bone quality in sites without previous bone grafting. When assessing sites with history of bone grafting, the CBCT should be interpreted with caution, especially if xenografts were used.

PMID:34615780